Active NPI
Town of Orange Park
Doing business as Orange Park Fire Department
- Ambulance
- Orange Park, FL
National Provider Identifier
1639721954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- TOWN OF ORANGE PARK
- Doing business as
- Orange Park Fire Department
- Practice address
- 2025 Smith St
Orange Park, FL 32073-5579 - Phone
- (904) 264-3411
- NPI assigned
- Jul 16, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John M Contestabile
- Title
- Interim Fire Chief
- Phone
- (904) 278-2083
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
2025 Smith St
Orange Park, FL 32073-5579
Mailing address
PO Box 161993
Altamonte Springs, FL 32716-1993
Phone (904) 264-3411
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104429700 | Medicaid | FL | |
| P02315588 | Other | FL | RAIL ROAD |
Other names 1
- Orange Park Fire Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190917001917 | FL | Part B Supplier - Ambulance Service Supplier | 0143559104 | Practice locations: Orange Park, FL |
National Provider Directory
National Provider DirectoryLocations
2025 Smith St
Orange Park, FL 32073
Phone (904) 264-3411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1630022400000",
"number": "1639721954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 161993",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327161993",
"telephone_number": "904-264-3411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 SMITH ST",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735579",
"telephone_number": "904-264-3411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOWN OF ORANGE PARK",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-16",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A",
"authorized_official_last_name": "CONTESTABILE",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "INTERIM FIRE CHIEF",
"authorized_official_telephone_number": "904-278-2083"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104429700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "P02315588",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Orange Park Fire Department",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Orange Park Fire Department",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.